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General NPI Number Information
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NPI Number | 1013611086
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Entity Type | Individual
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Provider Name | AMANDA M SHENK
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Gender | Female
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 24 W MAIN ST STE B
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City | FRONT ROYAL
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State | VA
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Zip | 22630-2655
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Country | US
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Telephone | 540-252-3317
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Fax |
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Provider Business Mailing Address
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Address Line | 214 LEE ST
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City | FRONT ROYAL
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State | VA
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Zip | 22630-3220
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Country | US
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Telephone | 540-671-0250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | PGP-0641038
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License Number State | VA
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